Improving CMS Hospital Star Ratings by reducing readmission rates

CyraCom Marketing
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CMS Overall Hospital Star Ratings are available online and reviewable by potential patients deciding where to seek treatment. This represents a challenge for healthcare organizations whose ratings are on the low side.

Improving these ratings has become an executive-level priority for many hospital leaders. If you manage language services for a hospital or healthcare organization, you may be able to help by reducing readmission rates for limited-English proficient (LEP) patients.

How Readmission Rates Impact Hospital Star Ratings

Readmission rates play a large role in determining a hospital s CMS star rating: 22% of a hospital s overall score is calculated based on readmissions. These rates also impact hospital funding: 2,600 hospitals lost $564 million in Medicare reimbursements in 2018 as a penalty for readmission rates the government deemed too high.

The Impact of LEP Patients on Readmission Rates

Non-English speaking individuals are readmitted to the hospital at a significantly higher rate than native English speakers Chinese and Spanish speakers are at particularly high risk according to NCBI.

Why? A no-longer-available study published in the Dartmouth Atlas reviewed 10.7 million Medicare records and found that patients tend to readmit when they do not:

– Understand their diagnosis

– Know which medications to take and when

– Comprehend important information or test results

– Schedule a follow-up appointment with their doctor

– Receive adequate care at home

Each of these factors is likely impacted by a patient s inability to converse with their providers in English. And the study concluded that these avoidable readmissions cost Medicare $17 billion a year.

These findings identify clear provider/patient communications as essential for reducing readmission rates. And since these rates are highest among LEP patients, improving communication with these patients in particular will likely make an outsized impact. That means enlisting the services of a qualified, professional interpreter – whether on staff or via phone or video interpretation – at every stage in the continuum of care.

 

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